The concept of concierge medicine, established in 1996, stands out for its focus on enhancing accessibility to healthcare providers and customized medical services. It is centered on key principles such as giving priority to quality and individualized care, managing a smaller group of patients to ensure improved service accessibility, and nurturing enhanced continuity in personalized treatment. This review explores various aspects of how concierge medicine impacts healthcare, encompassing areas such as patient satisfaction and involvement, health outcomes, preventive care, healthcare expenses, and ethical and legal considerations. While the affirmative influence of concierge medicine on individual healthcare has been evidenced in terms of patient contentment, active patient participation, preventive care, and early identification of illnesses, there remains a dearth of research data to firmly establish the correlation between concierge medicine and health-related outcomes. Moreover, comprehensive longitudinal studies focusing specifically on the economic and policy implications of concierge medicine are currently lacking. Therefore, further research, particularly in the domain of health economics, is crucial to comprehensively comprehend the implications of this approach. Similarly, there is a necessity for studies that can conduct a comparative analysis between the concierge medicine model and traditional healthcare models, aiming to draw more robust and definitive conclusions.

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Resource allocation generally involves a tension between efficiency and equity, particularly in health care. The growth in exclusive physician arrangements using non-linear prices is leading to consumer segmentation with theoretically ambiguous welfare implications. We study concierge medicine, in which physicians only provide care to patients paying a retainer fee. We find limited evidence of selection based on health and stronger evidence of selection based on income. Using a matching strategy that leverages the staggered adoption of concierge medicine, we find large spending increases and no average mortality effects for patients impacted by the switch to concierge medicine.

We examine how patient numerical ratings and specific words in written reviews of family physicians and internists in the states of California and Florida differ based upon concierge doctor status. Data are drawn from Healthgrades.com, one of the largest providers of online reviews, and a machine-learning sentiment analysis is used to determine the predictors of concierge status and numerical patient ratings. We find that reviews of concierge doctors are more likely to contain technical words associated with health care, such as \"staff\" and \"office,\" compared with traditional physicians. In contrast, interpersonal bedside-manner words, like \"listen\" or \"concerns,\" are most likely in reviews for nonconcierge doctors. We further determine that, whereas interpersonal words exhibit both positive and negative effects on numerical ratings, technical terms seem to primarily correlate negatively with patient scores for all doctors. The present work represents a first step towards understanding the measures of quality of care that relate with the patient experience, and in particular with respect to the growing field of concierge medicine. It is also the first attempt we are aware of that employs sentiment analysis in this context.

Dignitary medicine (DM) involves the provision of healthcare to government leaders and other high-profile individuals collectively referred to as \"dignitaries.\" Due to the unique circumstances around their lifestyle, dignitaries often receive suboptimal healthcare. We define the requisite skills needed to practice DM based on the available literature and provide a framework for training providers in these skills. A review of the English language medical literature focussing on adult subjects was performed, searching for terms such as \"dignitary medicine,\" \"VIP medicine,\" and \"protective medicine.\" Literature was gathered from CINAHL, Google Scholar, PubMed, EBSCOHost, and San Bernardino County Library databases and then analyzed by experienced DM providers. A total of 23 relevant articles were eligible for review. No meta-analyses on the subject exist. We found that existing studies highlight skills in wellness, executive health, and protective medicine, which form the backbone of DM. The burgeoning field of DM encompasses several disciplines and skills. We strongly recommend a structured curriculum for the field of DM, focused on dignitary wellness, executive health, and protective medicine.

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BACKGROUND: Direct primary care, one of several retainer-based practice models, is a niche practice type that offers an alternative to the traditional fee-for-service and insurance-based practices most prevalent in US health care. In Wisconsin, the prevalence of direct primary care practices is higher than in most other states. The market for direct primary care practice may be growing along with the industry shift to value-based care and an increase in physicians\' desire to reduce the increasing administrative work and regulations that detract from patient care and increase burnout. Many physicians are seeking ways to reduce these burdens so they have more time with patients. Some are transitioning their practice to a retainer-based model, such as direct primary care, in which they collect a retainer from patients in exchange for more time, freer communication, and less paperwork.
OBJECTIVE: The objective of this review is to provide information about the direct primary care practice model, possible drivers to this model of care, and its advantages and drawbacks for physicians and patients. This discussion also aims to evaluate the care model\'s place in the shift to value-based care, and key positions and policy from leading organizations.
METHODS: A literature review was conducted to collect and analyze current evidence about the prevalence of retainer-based practices, the average fees associated with such models, the contributors to physician burnout that may lead to a transition to the direct primary care model, and the relevant ethical and policy considerations associated with direct primary care.
CONCLUSIONS: Eighty-two percent of Wisconsin physicians report some level of burnout. Estimates demonstrate an increase in the number of direct primary care practices, and that Wisconsin is among the top 3 states with the highest number of direct primary care practices. The literature suggests that since the early stages of modern retainer-based models, patient fees have decreased and the patient base for these practices has expanded. The practice model is relatively rare, although there are indicators that its presence has increased in recent years.
CONCLUSIONS: Physicians seeking strategies to reduce administrative burden, spend more time with patients, or simply streamline their practice may experience benefits in transitioning to a retainer practice such as direct primary care. There are foundational concepts about direct primary care, including advantages, drawbacks, and ethical considerations, to heed when transitioning to this model. There is a need for further research to quantify key data about direct primary care and its effects on patient outcomes and physician burnout and satisfaction.

Recently, the major professional societies in Radiology have embarked upon a campaign to increase the patient-centeredness of Radiology. At the foundation of this initiative is direct communication between radiologist and patient, an area that has long been a deficiency for the field. Historically, there have been a number of barriers to effective radiologist-patient communication including logistical challenges, a negative impact on efficiency, and uncertainty of the role of the radiologist in discussing results with patients. The ubiquity of the internet and the wealth of applications that allow the safe transmission of robust information provide a number of opportunities for the radiologist. The purpose of this article is to review key web-based platforms that can improve communication, highlight unique initiatives being employed by thought leaders, and emphasize why radiologist-patient communication is paramount to the patient centered imaging experience.

Concierge medicine, sometimes called retainer medicine, is a model of care in which the patient directly pays the physician a yearly fee — averaging $1,800 — in exchange for enhanced services.1 A 2016 survey showed that 4 percent of U.S. physicians reported themselves as being in a concierge practice.2